Last update: May 13, 2019

Minocycline

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

Antibacterial of the tetracycline group with similar properties and uses to tetracycline.
Prescribed for urinary, skin and respiratory infections and for the treatment of acne.
Oral administration of two daily doses.

Excreted in small and not clinically significant amounts in breast milk (Fulton 1992, Mizuno 1969). Being more liposoluble than other tetracyclines, excretion in breast milk is somewhat higher.

Intestinal absorption of tetracyclines is greatly diminished in lactating infants due to the formation of non-absorbable chelates with milk calcium (Pfizer 2015, Sandoz 2013, Mitrano 2009, Chin 2001). Doxycycline and minocycline have less affinity for calcium (Sandoz 2013), so they would not be of choice during lactation.

It should be considered the possibility of negative cultures in febrile infants as well as the possibility of gastroenteritis due to intestinal microbiome alterations in lactating infants of mothers who take antibiotics (Ito 1993).

it can transiently stain breast milk and other body fluids black (Sandoz 2013, Eisen 1998, Hunt 1996, Basler 1985).

Its prolonged used is not advisable because it may affect dental coloration, growth cartilage and intestinal flora of the infant (Pfizer 2015).

Until we have more published data on this drug in relation to breastfeeding, safer known alternatives may be preferable, especially during the neonatal period and in the case of prematurity.

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Tradenames

Main tradenames from several countries containing Minocycline in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 458 daltons
Protein Binding 55 - 76 %
VD 0,14 - 0,7 l/Kg
Tmax 1 - 4 hours
T1/2 11 - 26 hours
Theoretical Dose 0,075 - 0,12 mg/Kg/d
Relative Dose 2,3 - 3,6 %
Relat.Ped.Dose 1,8 - 3 %

References

  1. Pfizer. Minociclina. Ficha técnica. 2015 Full text (in our servers)
  2. Sandoz. Minocycline. Drug Summary. 2013 Full text (in our servers)
  3. Mitrano JA, Spooner LM, Belliveau P. Excretion of antimicrobials used to treat methicillin-resistant Staphylococcus aureus infections during lactation: safety in breastfeeding infants. Pharmacotherapy. 2009 Sep;29(9):1103-9. Abstract
  4. Chin KG, McPherson CE 3rd, Hoffman M, Kuchta A, Mactal-Haaf C. Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole. J Hum Lact. 2001 Feb;17(1):54-65. Abstract
  5. Eisen D, Hakim MD. Minocycline-induced pigmentation. Incidence, prevention and management. Drug Saf. 1998 Jun;18(6):431-40. Review. Abstract
  6. Hunt MJ, Salisbury EL, Grace J, Armati R. Black breast milk due to minocycline therapy. Br J Dermatol. 1996 May;134(5):943-4. Abstract
  7. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993 May;168(5):1393-9. Abstract
  8. Fulton B, Moore LL. Antiinfectives in breastmilk. Part II: Sulfonamides, tetracyclines, macrolides, aminoglycosides and antimalarials. J Hum Lact. 1992 Dec;8(4):221-3. Review. No abstract available. Abstract
  9. Basler RS, Lynch PJ. Black galactorrhea as a consequence of minocycline and phenothiazine therapy. Arch Dermatol. 1985 Mar;121(3):417-8. No abstract available. Abstract
  10. Mizuno S, Takata M, Sano S, Ueyama T. [Minocycline]. Jpn J Antibiot. 1969 Dec;22(6):473-9. Japanese. No abstract available. Abstract

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